Monday, 3 December 2012

China shows HIV treatment-as-prevention reduces transmission in couples

Antiretroviral treatment prevents HIV transmission within couples
by Michael Woodhead
Antiretroviral therapy should be offered as a "treatment for prevention" to HIV-positive people who have an uninfected partner, Chinese researchers have shown.
In a study of almost 39,000 HIV 'serodiscordant' couples, Prof Shao Yiming and researchers at the Chinese Center for Disease Control and Prevention in Beijing found that "treatment-as-prevention" reduced HIV transmission by a quarter, which they says suggests it  is a feasible public health prevention strategy.
In their study they found that rates of HIV infection were 2·6 per 100 person-years among the 14 800 couples who did not receive antiretrovirals, compared to 1·3 per 100 person-years among the 24 000 couples who received antiretrovirals.
The reduction in transmission was around 26% and was seen across almost all  subgroups except for couples in which the HIV-positive partner was infected by injecting drugs.
An accompanying editorial in the Lancet said the results were encouraging but it remained to be seen whether treatment-as-prevention could be implemented on a national scale.
"Can community, regional, national, and international expertise and resources be mobilised to offer testing to all at-risk people at least yearly, link all infected people to care, and offer antiretroviral therapy to a much higher proportion of infected people than receive it at present, alongside expanded combination prevention activities?Can we ultimately reverse the HIV pandemic with the treatment-as-prevention approach, by offering antiretroviral therapy at coverage far greater than has been achieved up to now? Answers to these questions depend on rigorous research into implementation and programme deployment, so that we can succeed in bringing programmes to scale," it says.
Read more: Lancet

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